This project will compare the efficacy of conventional hearing aids and personal assistive listening devices (ALDs) for the elderly hearing-impaired. The comparison will be made on the basis of self-reported handicap scales, quality-of-life scales, and measures of speech understanding. In addition, the differential effects of degree of peripheral hearing loss, central auditory processing disorder, cognitive deficit, personality traits, and social support factors on the successful use of either system will be assessed. A total of 280 elderly subjects will participate in the study. They will be initially screened to assure bilateral sensori-neural hearing loss, adequate physical health and adequate mental health. Then a series of predictor and outcome measures will be administered. Predictor measures will include pure-tone, immittance, and diagnostic speech audiometry, sociodemographic characteristics, a social support questionnaire, a personality inventory, and measures of memory, attention, and manual dexterity. outcome measures will include the Hearing Handicap Inventory for the Elderly (HHIE), a scale of social activity, a scale of life satisfaction in the elderly, an inventory of emotional status, and the SPIN test. Each subject will then be subjected to four treatment conditions: 1) hearing aid alone; 2) ALD alone; 3) hearing aid plus remote microphone; and 4) no prosthetic device (i.e., no treatment). The full set of pre-intervention outcome measures will be repeated after the completion of each treatment condition. Results will be analyzed in two ways. First, the difference between pre-intervention and post-intervention outcome measures will be compared for the two amplification systems. Second, the extent to which each of the predictor measures can explain differences in the outcome measures across the two amplification systems will be determined.